INFORMATION AND COMMUNICATION TECHNOLOGIES AUTHORITY (ICTA) Level 12, The Celicourt 6, Sir Celicourt Antelme Street Port Louis Mauritius Tel.: (230) 211 5333/4 Fax: (230) 211 9444 email: icta@intnet.mu TARIFF APPLICATION FORM INSTRUCTIONS 1. Every Tariff Application shall be submitted together with all the relevant information required in Sections 1 to 9 and shall include the following submissions in hardcopy and electronic copy. (i) a duly signed cover letter bearing the official letterhead and seal of the applicant (ii) a duly filled in and signed tariff application form together with all required additional information (iii) any further clarifications required by the ICT Authority based on the relevant submissions made by the applicant. 2. A Tariff application for ILD voice services shall be further accompanied by the relevant ILD Tariff costing template, which allows for the costing of ILD calls on a per destination basis. The forms are available at http://www.icta.mu/market/forms.htm 3. Hardcopies of applications are to be submitted ONLY to the Registry Unit of the Authority and shall be officially acknowledged by a receipt issued by the Authority, as per Section 11 below. 4. Electronic copies of applications to be submitted ONLY to tariffapplications@imail.icta.mu and shall be officially acknowledged by a receipt issued by the Authority, as per Section 11 below. IMPORTANT NOTICE Failure to comply with this section may result in the setting aside of the application on grounds of INCOMPLETENESS Company Name: Registered Business Address: Tel/Fax: Contact Person: Email: SECTION 1: DETAILS OF APPLICANT SECTION 2: PURPOSE OF TARIFF APPLICATION Submission of New Tariffs Revision of Existing Tariffs Discounted Tariffs & Special considerations SERVICE for which Tariff Application is being submitted: LICENCE under which Tariff Application is being submitted: SECTION 3: SERVICE DESCRIPTION DESCRIPTION of Service for which Tariff application is being submitted: TERM during which proposed tariff shall apply: QUANTITY in which service shall be supplied: 1
ONE-OFF Charges (if applicable): SECTION 4: CHARGES PAYABLE Installation Registration Activation Other: RECURRENT Charges by Service / Package: SURCHARGES: Non Payment Other: 2
SECTION 5: COSTING FOR SERVICE CATEGORY / SERVICE LINE / PACKAGE / OFFER / PLAN Capital Expenditures: (CAPEX) Total (Rs) Investment in Network infrastructure Investment in Equipment Investment in Other Assets (Please specify): TOTAL CAPEX Total Number of Units of Usage or Subscriptions (Minutes, Megabytes, MIU.KM, lines, etc ) CAPEX PER UNIT OF USAGE OR SUBSCRIPTION Prescribed Contributions: USF Fraud Tracking Total (Rs) USF / Fraud Tracking Operational Expenditures: (OPEX) Access charges (Leased circuits, wholesale connection, etc) Interconnection Network Operational & Maintenance Costs Depreciation of Network Infrastructure Depreciation of Equipment Depreciation (Others) Amortization (Including initial licence fee) Administrative expenses (Including licences, billing, etc ) Marketing & Distribution Finance Charges Others: Total (Rs) TOTAL OPEX Total Number of Units of Usage or Subscriptions (Minutes, Megabytes, MIU.KM, lines, etc ) OPEX PER UNIT OF USAGE OR SUBSCRIPTION Note 1: Sections 5 & 6 establish the indicative historic or current cost breakdown for typical information and communication services, by identifying a list of cost elements that shall be required for due processing by the Authority. Note 2: The applicant may submit separate customized costing schedules. In case a service line / plan / package is being introduced or modified, the costing schedules shall cover but not be limited to the entire service category in operation, together with a breakdown of cost as allocated to all service lines / plans / packages etc, falling under the said service category. Note 3: The customized costing schedules shall cover but not be limited to the cost elements in Sections 5 & 6 3
SECTION 6: : EXPECTED MARK-UP FOR SERVICE CATEGORY / SERVICE LINE / PACKAGE / OFFER / PLAN Service / Package / Offer Proposed Tariff (Exclusive of Taxes) Cost of Service Provision (Exclusive of Taxes) Mark-up (%) SECTION 7: SUBSCRIBER BASE Number of Subscribers to Existing Service / Package / Plan as at date of application Monthly Forecast [New Connections / Disconnections] to Existing or New Service / Package / Plan Yearly Forecast [New Connections / Disconnections] to Existing or New Service / Package / Plan Total SECTION 8: PERFORMANCE CHARACTERISTICS / TECHNICAL DIAGRAM / TERMS & CONDITIONS To be submitted at the time of an INITIAL tariff application under the new framework for submission of tariff applications and subsequently, for the LAUNCH of a new service category / service line / package / offer / plan, OR for any ALTERATION thereto The PERFORMANCE CHARACTERISTICS of the service, as being applied by the operator, and in the form of an applicable Service Level Agreement or contract, to be submitted as a separate ANNEXURE The TECHNICAL information on the network configuration including the transmission capacity and network elements to be utilised for the provision of the service, to be submitted as a separate ANNEXURE Any other general or specific TERMS & CONDITIONS as applicable for service provision between the public operator and the end user to be submitted as a separate ANNEXURE SECTION 9: DECLARATION I certify that the information I have given is true and correct to the best of my knowledge. I agree to comply with any terms, conditions or restrictions which the Information and Communication Technologies Authority may impose, in pursuance to its statutory duties and powers, and to be bound by the laws and regulations in force. Applicant's Signature: Applicant s Seal: Signatory's Name: SECTION 10: FOR OFFICE USE ONLY Received by: Signature: ICTA's Seal: Reference: 4
SECTION 11: ACKNOWLEDGEMENT OF SUBMISSION OF TARIFF APPLICATION Received by: Signature: ICTA's Seal: Reference: CONDITIONS OF ACKNOWLEDGEMENT: 1) This acknowledgement constitutes the OFFICIAL RECEIPT following the submission of your tariff application to the REGISTRY UNIT of the ICT Authority. 2) The submission of a tariff application to the REGISTRY UNIT of the ICT Authority, after its normal working hours, shall be duly acknowledged by the next working day. 3) This acknowledgement DOES NOT by any means imply that your tariff application is deemed to be COMPLETE. 5